Over the last decades the number of patients suffering from chronic diseases has dramatically increased, whereas the total expenditures for health care provisions have almost remained constant. This fact has in previous days caused considerable economic pressure on health care providers. To provide an up-to-date service, health care providers or medical facilities need to invest large amounts of money in state-of-the-art modalities, for example magnetic resonance imaging (MRI) scanners or CT-scanners. To make these large investments worthwhile, medical facilities, such as a practice of a family doctor, a radiology department of a hospital, a whole hospital as such or even regional groups of several hospitals and surgeries need to increase their patient throughput in order to amortize their investments.
If, for example, a patient is referred to a radiology department there are several sections you could divide his or her visit into.
In the following parts of the text, for clarity's sake only the male form of a subject is used, without excluding female subjects in the referred context. So the patient may be construed as male or female and vice versa, wherever appropriate.
Sections into which the clinical pathway of the patient could be divided into could be for example: the patient arrives at the radiology department and admits himself to the help desk, the patient waits within the department's waiting area, the patient is about to enter the changing room to get redressed/undressed in order to enter a medical modality, the patient is making his way to the actual modality, such as a CT-scanner, the patient is making his way to the info desk, the patient is returning back to the ward he came from, the patient may be leaving the medical facility, the patient is being examined in another department.
For a medical facility there are in general two different types of patients. Some patients do stay for a certain period of time in one of the wards of the hospital as so called in-patient. There is a second group of patients who deliberately came to the medical facility such as the radiology department for a particular examination or a plurality of specific examinations or a specific treatment. This second group of patients leaves the facility once the particular examination or the specific treatment is finished. This second group of patients is called out-patients. The clinical pathway for in-patients is different from that for out-patients.
Although these are typical clinical pathways a patient has to follow there is just a limited extent to which these clinical pathways can actually be planned and organized. This is simply due to the requirements given within the medical facility, for example a radiology department. Such requirements within the medical facility could be for example: some emergency cases get admitted to the department which need to be treated immediately, some treatments may take longer than expected, one of the resources used such as a scanner may fail due to a hardware break-down.
This may cause several examinations that have been scheduled for a certain time to be rescheduled or moved to a different medical modality, for example instead of an MRI scan one could reroute the patient to a CT scanner in case the MRI scanner dropped out or in response to an urgent emergency scan at the MRI scanner, if planned examination allowed for a CT scan.
Further, it might as well occur that a patient has to travel between different departments of different hospitals because some medical modalities might only be available within a certain department of another hospital. So actually the concept of patient pathways or clinical pathways is not only valid across or within a specialist surgery or a single department of a clinic or several departments within one hospital. The concept of clinical pathways does as well hold for the patient visiting several departments across different hospitals or the patient seeing several specialist consultants.
In order to facilitate the clinical pathways within health care providers, there is a need to control and optimize the clinical pathways within these health care providers. Suppose the MRI scan of a patient Fisher needs to be postponed as there was an emergency case coming in that immediately needs an MRI scan. In order to inform patient Fisher, it is necessary to know whether he is already at the radiology department, making his way to the radiology department, already in the changing room, at the restrooms or just waiting in the waiting area of the radiology department.
Up until now, it is the task of the staff working at the medical facility, for example the radiology department, to actually retrieve the patient and inform him about the change of schedule and the postponed MRI scan.
The patient could either be retrieved via some loudspeaker announcement, by personal follow-up or staff seeking the patient Fisher, probably checking the corridors between the ward the patient came from and the radiology department.
This process is inefficient, time-consuming and binding resources. As a consequence, other tasks with respect to employee, staff or nurse etc. are suspended/delayed.
Thus, exact localization of patients can help to overcome such losses in efficiency and to streamline processes.
It will be appreciated by the person skilled in the art that there is a need to clearly localize the patient at a given time in order to streamline processes or clinical pathways within medical facilities.
Furthermore, also mobile resources, such as medical equipment, clinical images, documents and the like need to be localized.
It might very well happen that some resources, for example a mobile ultrasound unit or just printed clinical images (maybe images from an MRI scan), need to be retrieved before a radiologist could actually stage a cancer or carry out any other diagnostic steps for which these clinical images are crucial to come to a diagnosis.
Although a clinic is supposed to be well-organized, it might easily happen that an image is supposed to be within the radiology department when in fact it is currently making its way to the patient's ward. This may be because the ward has initiated cancer staging for patient Fisher after a senior consultant referred him to the radiology department when visiting the ward. Hence the ward may request the clinical images such that the senior consultant can see them next time he visits the patient at the ward.
So again, finding the resources such as a mobile ultrasound scanner or some clinical images is time-consuming and an inefficient use of time and manpower.
Considering the said, a need for an automated process to support such scenarios is taking shape. Ideally this should be done automatically and without a person necessary to find these resources.
Retrieving patients or resources could as well be done in a semi-automatic way such that the system states that patient Fisher's x-ray images are within the internal ward and not as expected within the radiology department. Once this information is retrieved, in a semi-automatic system an employee of the radiology department could be sent to the internal ward to actually pick up the x-ray images of patient Fisher.
It is not only the resources and patients one would like to know their whereabouts at a given point in time. It is also the clinical pathways that probably need to be changed due to an emergency case as stated above. If this change in pathways is done by a person, it would be a rather time-consuming process as several pathways of a plurality of patients need to be taken into account as well as all available resources, such as MRI or x-ray scanners that are within the medical facility and a plurality of examinations that have been scheduled for a certain point in time.
It will be apparent to a person skilled in the art that this task could be very well solved by an automatic system to rearrange/reschedule and optimize clinical pathways of the patient or a plurality of patients within any medical facility, in case there was an ad-hoc change of schedule due to, for example, an emergency patient.
It is one aspect of the present invention to provide means of localizing either a plurality of patients and/or a plurality of resources.
Within the remainder of this disclosure resources are to be construed as devices or objects needed to carry out a step within a clinical pathway. There are mobile resources such as for example a mobile ultrasound scanner or diagnostic images of a patient. Further within the context of this disclosures individuals working within the medical facility, such as clinicians, employees, nurses and the like shall be referred to as human resources. Some of the resources present within a medical facility do not change their location, such as for example an MRI scanner.
According to another aspect of the invention, means of localization are achieved for example by means of using special cameras within the hospital and/or an RFID chip that is attached to a patient or attached a resource such as a mobile ultrasound unit or clinical images of a patient. RFID is standing short for Radio Frequency Identification.
The present invention allows localizing a patient out of a plurality of patients or a resource out of a plurality of resources. Within a next step of dealing with patient pathways and resources it would be possible to deliberately inform a specific patient that his scheduled examination has been postponed. Alternatively one could inform the patient that his schedule had been rearranged. His blood test was preponed before the MRI scan that initially was scheduled before the urography and having a blood sample taken.
According to a further aspect of the invention, due to the exact localization of the patient, it is possible to inform the patient by some means of graphical display that there was a change of plan and he is now supposed to go the urology department instead of staying within the waiting area of the radiology department.
The provision of information to the patient after a change in the clinical pathway could as well be done as a semi-automatic process, without any limitation.
According to a further aspect of the invention a clinical system would inform the employees of the medical facility, for example the radiology department that patient Fisher is sitting within the waiting area. Then a staff member would actually address him personally and tell him that he has now to go to the urology ward to get an urography done before MRI scanning the kidneys for any deformation that could not be recognized within the x-ray urography.
With the above it has been clearly explained that there is a need within the field of controlling and optimizing clinical pathways of patients within and across health care facilities and a need of precisely localizing the patients or the resources. This means of localizing could be for example done by means of RFID technology, a cellular phone, a camera or any other localization device, preferably a contact-less localization device.
One could also locate a staff member e.g. with a certain clinical and/or language skill required in case of emergency.